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hope to increase our Out-Patients' Sessions to three per week
early in 1946.
As the numbers have increased during the latter months,
an appointment system has been instituted. This has been
found to work exceptionally well, as the majority of patients,
realising that the system is for their benefit, do endeavour to
keep their appointments.
In these difficult days, however, it is inevitable that some
patients do not keep strictly to their appointments, the usual
apology and explanation being that of queueing for food, soap,
and even coal.
The services of our Psychiatric Social Worker, Miss
Batkin, have been invaluable to the clinic. She is in attendance
at each session to take full social histories of the new cases,
and as this saves the doctor's time, he can give more attention
to treatment of the patients. The Psychiatric Social Worker
arranges appointments for new patients—seeing relatives when
necessary, while some of her most useful work is co-operating
with the Employment Exchange in finding new or suitable jobs
for patients. We have found the Employment Exchange most
helpful in this part of our work.
Of the 65 cases treated—27 were patients who had been
in-patients of the West Ham Mental Hospital and wished to
avail themselves of the clinic's help after discharge. These expatients
are very regular in their attendance, and we find that
they are more able to carry on their everyday activities and
meet responsibilities knowing that they have the clinic team to
lean on. Of these discharged cases, five have since relapsed
and been re-admitted to hospital as Voluntary Patients, on the
advice of the doctor.
Of the remaining 38 new cases—14 were admitted to
hospital for more intensive psychiatric treatment, such as
insulin shock, or electrical convulsant treatment. In these cases
the benefits of early hospital treatment are noticeable. For
example, several Schizophrenics in the early stages of the
disease have been admitted for insulin shock therapy and have
been discharged recovered at the end of three months. Only
two patients refused to consider hospital treatment as advised,
and discontinued attending the clinic. Most of these cases were
referred to the clinic by the local general practitioners and by.
the welfare doctors, while a few were referred by the Citizens'
Advice Bureau.
It is interesting to note that all cases admitted to hospital
were voluntary patients, although in the first instance, two
were admitted on "urgency order." Two cases, both children,
suffering from congenital mental defect, were referred to the
Child Guidance Clinic for mental testing, and disposal.
A limited number of children are treated at the clinic, but
wherever the doctor considers that the child- will derive benefit
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